Implications for practice and research

Women taking sodium valproate should be counselled about potential risks well in advance of pregnancy.

Further research is required to understand whether lower doses reduce the risk of autism to population levels.

Prospective longitudinal studies assessing all children are necessary to clarify the full extent of risk associated with prenatal
medication exposures.

Context

The clinical management of women with epilepsy during pregnancy is complicated by the potential teratogenicity of medications
needed to control seizures. Past research about the relationship between prenatal exposure to antiepileptic drugs and major
congenital malformations has improved understanding of the immediate effects for the child, with recent studies highlighting
the long-term impact on cognitive development.1,2 …